6. Project Summary Abstract Currently 17 percent of the total U.S. nursing work force is foreign-born. Many of these highly qualified professionals speak U.S. English as a second language and struggle to communicate effectively with clients and colleagues. The Intercultural Communication Workshop (hereafter, ICW), is a multimedia, internet-based educational tool designed to improve the overall communicative competence of foreign- born nurses. ICW Phase I integrates instruction in speech intelligibility with contextual information about communication, culture, and healthcare in the U.S. In Phase II, the user interface and navigation will be refined based on the findings of the Phase I field trial and the content will be expanded to address the language needs of diverse native speakers. Interactive role-play simulations will provide opportunities to practice new communication strategies. A multi-method, multi-measure two-group randomized controlled trial will be used to evaluate the educational effectiveness of the ICW, using an intent-to- teach approach analogous to the intent-to-treat approach for evaluations of effectiveness of biomedical interventions. Successful completion of ICW and a satisfactory demonstration of educational effectiveness will result in a new, low-cost, efficient resource for foreign-born nurses and their employers, lead to gains in speech intelligibility and communication skills in U.S. English for foreign-born nurses, enhance the intrinsic rewards of their profession for foreign-born nurses, and ultimately improve retention of foreign-born nurses in challenging and rewarding positions in the healthcare workforce. ICW will also yield two online assessment tools that facilitate the work of second-language acquisition and speech & language professionals. The use of computer-based training to improve the speech intelligibility and communication skills of foreign-born nurses addresses NINR's strategic plan for Adopting, adapting and generating new technologies for better health care.